CMS 1500 alternate fee source update

Effective July 1, 2025, we will be expanding the alternate fee sources provided by RJ Health Systems, one of our current alternate fee sources, to include Wholesale Acquisition Cost (WAC) pricing for medical drugs, injectables and radiopharmaceuticals when the primary fee source does not have a rate. This update is in effect for all states and UnitedHealthcare plans. Please note, this update does not apply to vaccines.

What this means for you

Your UnitedHealthcare Participation Agreement remains unchanged. This is a courtesy notice to enhance pricing transparency and help ensure reimbursement accuracy.